Journal of Behavioral Medicine

, Volume 35, Issue 6, pp 603–615 | Cite as

Predictors of adherence with self-care guidelines among persons with type 2 diabetes: results from a logistic regression tree analysis

  • Takashi YamashitaEmail author
  • Cary S. Kart
  • Douglas A. Noe


Type 2 diabetes is known to contribute to health disparities in the U.S. and failure to adhere to recommended self-care behaviors is a contributing factor. Intervention programs face difficulties as a result of patient diversity and limited resources. With data from the 2005 Behavioral Risk Factor Surveillance System, this study employs a logistic regression tree algorithm to identify characteristics of sub-populations with type 2 diabetes according to their reported frequency of adherence to four recommended diabetes self-care behaviors including blood glucose monitoring, foot examination, eye examination and HbA1c testing. Using Andersen’s health behavior model, need factors appear to dominate the definition of which sub-groups were at greatest risk for low as well as high adherence. Findings demonstrate the utility of easily interpreted tree diagrams to design specific culturally appropriate intervention programs targeting sub-populations of diabetes patients who need to improve their self-care behaviors. Limitations and contributions of the study are discussed.


Diabetes Self-care Logistic regression tree Chronic disease 



We gratefully acknowledge Dr. Jennifer M. Kinney’s helpful comments and editorial suggestions in the earlier version of this paper.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Takashi Yamashita
    • 1
    Email author
  • Cary S. Kart
    • 1
  • Douglas A. Noe
    • 2
  1. 1.Scripps Gerontology CenterMiami UniversityOxfordUSA
  2. 2.Department of StatisticsMiami UniversityOxfordUSA

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